PTSD/OCD Flashcards
(22 cards)
4 main Clusters of PTSD
- Intrusion
- Avoidance
- Negative Alterations in Cognitions and Mood
- Alterations in Arousal and Reactivity
Shown to improve all PTSD symptom clusters…
Sertaline (ZOLOFT)
Sertraline
ZOLOFT
Venlafaxine
EFFEXOR
Reduces avoidance/numbing and hyperarousal clusters
SNRI-Can increase BP
Nefazodone
SERZONE
Post synaptic 5 HT2
Improved symptoms in a vet population and showed equivalence to Sertraline in 2 fair trials
-Liver Toxicity prevents it from being 1st line, avoid in liver dx
LESS SEXUAL SIDE EFECTS THAN SSIRS
MAOI 2nd line for PTSD only one
Phenelzine
Phenelzine
NARDIL
Risk of HTN crisis, hypotension, anticholinergic effects
Monotherapy for PTSD Options….
Sertraline*
Paroxetine
Venlafaxine*
Fluoxetine
Nefazodone low
Imipramine veryylow
Phenelzine
Prazosin can be given for…
TX in association with nightmare (no recommendation f or or against)
Trauma Focused psychotherpies have what place in PTSD treatment
1st line
Acute phase of treatment
8-12 weeks
Preferred 1st Line for OCD
Fluoxetine
Sertraline
Fluvosamine
Paroxetine
Fluoxetine
Prozac
Fluvoxamine
Luvox
Paroxetine
Paxil
Sertraline
Zoloft
TCA recommended as 2nd line for OCD Tx
Clomipramine
Clomipramine
5HT, NE, Muscarinic, H1, Alpha1, Sodium channels in heart and brain
Major Active Metabolite
Major SE
Orthostatic hypotension, dizziness, arrhytmias, Anticholinergic, Histamine related sedation and weight gain
Risks to consider with clomipramine…
Lethality in overdose in pts with suidical ideation
QT
Seizures
Anticholinergic (effect narrow angle glaucoma, contipation, elderly probs)
Augmentation for refractory patients may consider adding..
Memantine or Topiramate
Also discussed that Abilify may help as well
Clinical tool for OCD
YBOCS
1st line for Kids OCD
CBT + SSRI
